PROSPECTIVE RANDOMIZED DOUBLE-BLIND TRIAL OF NEUROLYTIC CELIAC PLEXUSBLOCK IN PATIENTS WITH PANCREATIC-CANCER

Background In a randomized double-blind study the efficacy of neurolyt ic coeliac plexus block (NCPB) was compared with pharmacological thera py in the treatment of pain from pancreatic cancer. Methods Twenty-fou r patients were divided into two groups: 12 patients underwent NCPB (g roup 1) and 12 were treated with pharmacological therapy (group 2). Im mediate and long-term efficacy, mean analgesic consumption, mortality and morbidity were evaluated at follow-up. Statistical analysis was pe rformed with the unpaired t test, Mann-Whitney U test and Fisher's exa ct test. Results Immediately after the block, patients in group 1 repo rted significant pain relief compared with those in group 2 (P < 0.05) , but long-term results did not differ between the groups. Mean analge sic consumption was lower in group 1. There were no deaths. Complicati ons related to NCPB were transient diarrhoea and hypotension (P not si gnificant between groups). Drug-related adverse effects were constipat ion (five of 12 patients in group 1 versus 12 of 12 in group 2), nause a and/or vomiting (four of 12 patients in group 1 versus 12 of 12 in g roup 2) (P < 0.05), one gastric ulcer and one gluteal abscess in group 2.Conclusion NCPB was associated with a reduction in analgesic drug a dministration and drug-related adverse effects, representing an effect ive tool in the treatment of pancreatic cancer pain.